Erwin Rommel Memorial, place of his suicide with a cyanide pill, Herrlingen (2019) Courtesy - Wikipedia
A significant difference between risk factors and suicide methods was highlighted. Persons with financial constraints chose to hang themselves while those with marital conflict preferred to poison themselves compared with other methods
ADEREMI MEDUPIN
Why the Subject of Suicide?
When I read in an online post of September 26, 2024 on the Associated Press page, that: “Preliminary data shows that a little over 49,300 suicide deaths were reported in 2023” and that “over 49,000 people died by suicide in 2022”, all in the United States of America, translating into one suicide every 1 hour and 40 minutes, which means that every day, approximately 14 young people between the ages of 15-24 die at their own hands, I was shocked and pushed to learn more about the sobering statistic. One literature I accessed almost immediately was a piece written way back in 2003 by Dave E. Marcotte, titled: “The Economics of Suicide, Revisited”, published in the Southern Economic Journal Volume 68, Issue Number 3. So, Economists have actually paid attention to this sobering subject for that long, I wondered aloud.
Coincidentally, not long ago, there was a shared photo via WhatsApp of a young man, looking well-dressed but who hanged himself somewhere in the outskirts of the Nigerian Federal Capital Territory. What could have pushed the man to that irreversible act of destroying what is considered the most precious asset to every human being? In this context, therefore, a Google entry made on April 28, 2023 which states that, “a person's most valuable asset in life is mindset” -appears to have skipped a critical step and therefore wrong. This is because it omits the fact that life precedes mindset. Indeed, we can be talking of a mindset only if there’s a mind and there can be no active mind outside of an existing life. Dear reader- am I communicating?
We value human life in a way that assumes we possess a sacred something not found in beings like lambs, dogs, or mosquitoes. As captured on the Big Think platform, “the sanctity of life is the idea that human lives are inherently valuable – more valuable than any other material thing there is”. If we approach suicide from the other angle, we are confronted by the question: What is wrong in killing people? The nuanced answer provided on the same Big Think platform is that: “Nearly all of us seem to have an unquestioned assumption that every person should continue to live; that to kill another human being is a wrong beyond no others.
We unthinkingly accept that there’s something about human beings that we ought to protect and, if at all possible, avoid harming. We value human life in a way that suggests we have a magic and a sacred something that lambs, turkeys, or mosquitos do not possess”. Take this along with instances of people killing others and committing suicide thereafter.
Tessa Lynn- a therapist and author, posed two interesting and interrelated questions on the popular Quora Digest platform, on June 30, 2024- namely: (i) What is the purpose of human life? and (ii) Why do we see so much suffering in various forms of life? The following informed answer to the first question is evidently insightful and possibly provocative, which is that, “from a spiritual perspective, the purpose of human life is for each person to realize their full potential with the guidance of their in-dwelling spirit, which will also provide opportunities for the growth of the spirit”.
As to observable human suffering around us, Lynn’s position is that, much of it “is due to the effects of cultural and societal norms or those of governmental policies, the responsibility for which lies with the individuals, groups, and institutions involved and their determination, or lack of it, to act for the greater good”. In essence, therefore, human suffering is mostly inflicted by humans on other humans, which is the responsibility of the one who is inflicting it but is also influenced by genetics, personality, mental health, and the environment. A big question is: can we quantify human life in monetary terms?
Questioning the Appropriateness of Attaching Monetary Value to Human Life
Whereas, solely on the unique nature of the individual human life the argument can easily be made that it is supremely precious, so, can its value be expressed in monetary terms as implied in the cost-benefit paradigm and practice by economists? Some people find the very idea of assigning a monetary value to life as meaningless and ethically wrong. Human life, it is argued, is not a commodity that can be traded against other goods; it should therefore not carry a price tag. In other words, ethical questions arise.
As well known, a cost-benefit analysis is a process invoked by project evaluators in determining the economic benefit of a decision, so they can decide whether it's worth pursuing. In this methodological framework, both the costs and the benefits are measured in monetary terms, as for example in the case of projects for healthcare improvement: what is the value of the loss compared to the health gain? In the summary provided by Wikipedia, the motivation for placing a monetary value on life is to enable policy and regulatory analysts to allocate the limited supply of resources, infrastructure, labour, and tax revenue-explaining, that:
The value of life is an economic value used to quantify the benefit of avoiding a fatality. It is also referred to as the cost of life, value of preventing a fatality (VPF), implied cost of averting a fatality (ICAF), and value of a statistical life (VSL). In social and political sciences, it is the marginal cost of death prevention in a certain class of circumstances.
In many studies the value also includes the quality of life, the expected life time remaining, as well as the earning potential of a given person especially for an after-the-fact payment in a wrongful death claim lawsuit. As such, it is a statistical term, the value of reducing the average number of deaths by one. It is an important issue in a wide range of disciplines including economics, health care, adoption, political economy, insurance, worker safety, environmental impact assessment, globalization, and process safety.
The footnote to the above explanation by Wikipedia is interesting as it reveals the serious practical limitations of placing monetary value on human life. Hear the medium:
There is no standard concept for the value of a specific human life in economics. However, when looking at risk/reward trade-offs that people make with regard to their health, economists often consider the value of a statistical life (VSL). The VSL is very different from the value of an actual life. It is the value placed on changes in the likelihood of death, not the price someone would pay to avoid certain death.
In the specific case of insurance where the practice of life value quantification is the basic order of procedure, Human Life Value (HLV) as a quantitative measure is used to assess the economic value of an individual's life based on factors such as age, gender, occupation, income, and other relevant variables.
This is commonly employed in the industry to determine the amount of life insurance coverage a person should sign up to. The procedure follows the following principle: Your Human Life Value is a number unique to you, calculated roughly as your income multiplied by your years to retirement (using the typical age of 65). Generally, the rule of thumb for calculating human life value, according to life insurance companies, is multiplying income by 15 to 30, or insuring up to a client's net worth.
However, all these calculations and the enumerated measures aimed at lightening the burden of coping with the existential challenges of life and thus making the future to look promising, notwithstanding, across the globe, human beings commit suicide.
Global Incidence of Suicide
Suicide has been so wide in its occurrence that the World Health Organisation (WHO) calls it a “serious public health problem”.
According to reports, globally, more than 720 000 people die due to suicide every year. In ranking, suicide is the third leading cause of death among 15–29-year-olds; the rate is calculated per 100,000 population. Take Europe: in the UK, this figure stands at 10.7, while Cyprus is 3.5, Greece- 4, Italy -5.6 and Slovakia- 6.9, being among the lowest rates. With 11,558 deaths per 100,000 of the population and 200,000 suicide attempts in 2019, France is among the European countries with the highest rates. Of course, suicide does not just occur in high-income countries, rather, it is a global phenomenon, occurring in all regions of the world. In fact, close to three quarters (73%) of global suicides occurred in low- and middle-income countries in 2021.
Incidentally, across the globe, nowhere is it more serious than in Lesotho, with 87.5 suicides per 100,000 people. In his September 8, 2023 report on:”10 African countries with the highest suicide rate in 2023”, published in Business Insider Africa, Chinedu Okafor notes how, across Africa, while the continent often grapples with pressing issues such as poverty, infectious diseases, and political instability, the issue of suicide remains largely hidden from the public eye.
Accurate statistics on suicide in Africa are challenging to obtain due to underreporting, stigma, and limited data collection resources. However, the available data suggests that the suicide rate is on the rise in several African countries. Hardly surprising, the suicide rate varies across the continent, with some regions and countries experiencing higher rates than others. Based on the Report’s list, Southern Africa records the highest rates of suicides on the continent, as the accompanying Table amply shows.
10 African countries with the highest suicide rate.
Rank Country Suicide mortality rate
(per 100 000 population)
1. Lesotho 72.4
2. Eswatini 29.4
3. South Africa 23.5
4. Botswana 16.1
5. Zimbabwe 14.1
6. Mozambique 13.6
7. Cabo Verde 12.9
8. Central Africa Republic 12.3
9. Eritrea 10.9
10. Namibia 9.7
Source: Chinedu Okafor (2023), Business Insider Africa- September
In Nigeria, the age-standardized suicide rate was 6.9 per 100,000 population in 2019, across both sexes, however, male suicide rates were higher at 10.1 per 100,000 population. In the same year, Lesotho’s suicide rate stood at 87.5 per 100,000 population. As recalled on the website of Nigeria Health Watch on September 14, 2023 by Kenneth Ibe and Samuel Gada in their lead write up, titled: “World Suicide Prevention Day 2023: Creating Hope Through Action”:
In a video that went viral on social media recently, a Lagos socialite known as Mrs Salome [not her real name] parked her SUV on the ever-busy Third Mainland Bridge in Lagos State and made an apparent attempt to jump into the lagoon. Fortunately, swift intervention from passers-by prevented her attempted suicide. However, not everyone is so fortunate. This was the case for Chukwuemeka Akachi, a fourth-year student at the University of Nigeria Nsukka (UNN), who took his own life in 2019, leaving behind a suicide note on his Facebook wall
One crucial point to highlight here is the obvious fact of divergence between attempted suicides and completed suicides; the figure for the former logically greater than the latter. In other words, for every suicide there are many more people who attempt suicide. Wikipedia has a comic rendition on this relationship when it notes that: A suicide attempt is an act in which an individual tries to kill themselves but survives. Mental health professionals discourage describing suicide attempts as “failed” or “unsuccessful”, as doing so may imply that a suicide resulting in death is a successful or desirable outcome.
The logical question is: why do people commit suicide?
Typical Causes of Suicide
The reasons behind suicide are complicated. From sources across the web, the principal causes of suicide have been identified and as detailed in Wikipedia are the following:
√ Mental illness or psychiatric disability, which is a behavioral or mental pattern that causes significant distress or impairment of personal functioning
√ Drug or alcohol abuse: this can worsen thoughts of suicide and make you feel reckless or impulsive enough to act on your thoughts
√ Family history of suicide: Family violence, including physical, sexual, or verbal or emotional abuse.
√ Chronic pain: or chronic pain syndrome is a type of pain that is also known by other titles such as gradual burning pain, electrical pain, throbbing pain, and nauseating pain. A person who dies by suicide is often so consumed by pain that he can no longer think of anything but ending that pain.
√ Depression: Major depressive disorder, also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities.
Exposure to violence:
Thus, according to WHO, the reasons for suicide are multi-faceted, influenced by social, cultural, biological, psychological, and environmental factors present across the life-course. A publication by Russel Group titled, “Increases in suicide rate linked to ‘shocks’ in the economy” shared on March 11, 2024 shows a link between unexpected economic performance and a rise in the suicide rate. Researchers have found a strong connection between daily suicides, people’s expectations formed by professional economic forecasts and the subsequent outcome of actual economic performance. A negative ‘shock’ that emerges from the potential mismatch between reality and predictions can prompt an overwhelming sense of lack of identity and purpose of life among vulnerable sections of the population – sadly leading some to take their own lives.
The causal factors identified are connected to social stressors associated with suicide, namely: loneliness, rejection, and marital conflicts especially in developed countries, whereas inter-generational conflicts, love failure, and exam failure are found more in developing countries. As to the means of committing suicide, the most common is overdose-typically of poisonous items in form of medicines, drugs or alcohol, cleaning agents, insecticides, and garden chemicals; others are firearms-especially in the USA-where they are the most common means, accounting for over fifty percent of the total in 2020. This differs slightly from the European scene where hanging, poisoning by drugs, and jumping from a high place by far outstrip suicide by firearms.
In the case of Africa, hanging, pesticide poisoning, ingestion of toxic substances, and drowning, are the leading means with firearms trailing far behind them. There must be lessons to learn from this human pervasion and dictated public policy and private principle reactions.
Suicide Lessons and Reduction Policies
At the macro level of correlational analysis of low income countries, it has been found that, “for every $1000 increase in GDP per capita suicide rates are reduced by almost 30%, whereas in lower-middle and upper-middle countries suicide rates are reduced by 5%”. Across board, “the relationship of suicide rates with GDP suggests that suicide rates drop in times of economic expansion and increases in times of recession” Cascaded down to the micro level, there’s the general consensus among neoclassical economists whose language of rendition is typically, “that suicide occurs when the discounted stream of expected utility over a person’s lifetime is low, perhaps negative”.
Within this framework, suicide rates are expected to rise as lifetime income falls. What is beyond dispute is the fact that job loss and unemployment,, financial strain, eviction from rented apartment due to inability to pay due rent elevate suicide risks among affected individuals. This brings home the rude realization that life is tenuous for us all. Facing death with grace is the fulfillment of life, regardless of what you believe will follow. One thing is evident: We don’t appreciate what we have until it is gone.
At the strictly personal level, it is critical to reach out to others whenever you have suicidal thoughts- you may be at the very end of your tethers that you cannot pull out of by yourself. While it can be very difficult to “spot” someone in this state of mind, we all need to be alert to the warning signs. Specific measures have been recommended for preventing the occurrence of the suicide phenomenon, among them those from the WHO that include the following: i) limit access to the means of suicide (e.g. pesticides, firearms, certain medications); ii) interact with the media for responsible reporting of suicide; iii) foster socio-emotional life skills in adolescents; and iv) early identify, assess, manage and follow up anyone who is affected by suicidal behaviours.
Clearly beyond the focus of our theme, are two main moral issues regarding suicide: first, whether suicide is morally permissible, and if so, in what circumstances; and second, whether a person who knows that someone is contemplating or attempting suicide has an obligation to intervene and if so, how strong that obligation is. Persons with close contact to victims of suicide have some suggestions, such as these from someone whose brother committed suicide: While it can be very difficult to “spot” someone in this state of mind, we all need to be alert to the warning signs; and individual therapy and group therapy in any form is essential for helping survivors to deal with this grief.
All the above underscore the fact that we have the choice of making every minute count with the people we love. Inherent to our existence is that we learn, adapt, and grow. Health, happiness, and longevity are the payoffs for this. I come in peace, please.